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PC² You Decide — A Five-Step Approach to the Personal Choice Interview, Risk Assessment, and Patient Education

PC² You Decide is designed to guide providers in helping women choose a new contraceptive method and address concerns that their patients might have about the cardiovascular risks associated with combined hormonal contraception.

The five steps of PC² You Decide entail:

Patient concerns — Focus on the woman’s agenda for her visit.
Choices — Find out what options are acceptable to her.
Personal profile — Collect and interpret facts that may influence the suitability of her preferences (lifestyle, personal factors, health history).
Considerations — Discuss benefits, side effects, and risks of her preferred method(s).
You Decide — Partner with her in making the final decision. Give her supporting information and the contact information she needs for Q & A and follow-up care.

Download a PDF example of PC² You Decide.

The example below focuses on pregnancy prevention, combined hormonal contraception, and cardiovascular risks, but any other subject — obesity, mental health problems, etc. — could be addressed with this approach. Like SOAP notes, the PC² You Decide approach can be used intuitively by providers to guide them through comprehensive discussions with their patients in a timely manner.

PC² You Decide Pregnancy Prevention, Combined Hormonal Contraception (CHC), and Cardiovascular Risk
Five-Step Approach to Interviewing and Patient Education	Guiding Discussion for Contraception	Cardiovascular Risk Assessment	Supporting Tools
Step 1 (subjective)
Patient concerns Pregnancy Prevention	What are your pregnancy plans for the next year? The next five years? How would you feel if you were to get pregnant in the next 12 months? How important is it for you to prevent a pregnancy, now? What would you do if you got pregnant in the next 12 months?		Patient History Form (Patient should complete before the patient/provider interview)
Step 2 (subjective)
Choices Contraception Options	Are you currently using a method/methods of contraception? How satisfied/dissatisfied are you with this method? Are you interested in a new/different method? What are your needs for sexually transmitted infection (STI) protection?		Contraceptive Efficacy Tools
Step 3 (subjective and some objective)
Personal profile Factors that contribute to contraceptive choices and successful use (Provider reviews the completed Self-Administered Patient History Form as a guide for the discussion.)	Ability to remember/keep track of schedules Access to health care facility Affordability Age/cognitive abilities Blood pressure Comfort with one’s body Cultural/religious influences Findings of physical examination (if done) Habits – smoking, ETOH (alcohol), drugs Influence of others — partner(s), parents, friends Medical history Menstrual profile Surgical history Sexual behaviors Weight/BMI	Warning Signs See below.
Step 4 (assessment)
Considerations Questions & Answers	Contraindications Benefits — including non-contraceptive benefits Risks Side effects — what is client willing to tolerate Weight gain, irregular or no bleeding Evidence-based scientific information	CV Conditions Precluding Use of CHC Thrombophlebitis or thromboembolic disorder History of deep vein thrombosis or thromboembolic disorder Cardiovascular or coronary artery disease Valvular heart disease with thrombogenic complications Uncontrolled hypertension Diabetes with vascular involvement Headache with focal aura Major surgery with prolonged immobilization	Glossary of Risk Terms Patient Comparison Risk Tools Six-Step Plan: Responding to Adverse Medical Announcement
Step 5 (plan)
You Decide	Contraceptive decisions Instructions for contraceptive use Red flags — contact your health care provider if you have CV signs/symptoms Other health messages Follow up Periodic reassessment	Reinforce Warning signs: A–Abdominal Pain C–Chest Pain H–Headaches E–Eye Problems S–Severe Leg Pains	Instructions for use Warning signs Other good health messages Provider contact information Follow-up appointment

PC2 You Decide — A Five-Step Approach to the Personal Choice Interview, Risk Assessment, and Patient Education

PC² You Decide — A Five-Step Approach to the Personal Choice Interview, Risk Assessment, and Patient Education